Fulminant adenovirus hepatitis after hematopoietic stem cell transplant: Retrospective real-time PCR analysis for adenovirus DNA in two cases

Nozomu Kawashima, Hideki Muramatsu, Yusuke Okuno, Yuka Torii, Jun ichi Kawada, Atsushi Narita, Koji Nakanishi, Asahito Hama, Aya Kitamura, Naoya Asai, Shigeo Nakamura, Yoshiyuki Takahashi, Yoshinori Ito, Seiji Kojima

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Background: Viral infection is one of the major causes of mortality in patients undergoing hematopoietic stem cell transplant (HSCT). Systemic infection of adenovirus (AdV) has emerged as a not uncommon viral infection with significant morbidity and mortality as with cytomegalovirus and Epstein-Barr virus infection. Routine surveillance for these viruses has become a clinical practice and subsequent preemptive therapy improves patients' outcomes; however, the effectiveness of preemptive therapy for AdV has not been fully investigated in patients with a lethal form of AdV infection. Methods: Sequential AdV loads were retrospectively analyzed in children with fulminant AdV hepatitis after HSCT. Results: The AdV DNA became detectable (1 × 104 copies/mL) as early as 2 weeks after HSCT. These levels reached >1 × 108 copies/mL at the onset of fulminant hepatitis. However, we determined that γ-glutamyltransferase levels were elevated to >100 IU/L at least 2 weeks before the diagnosis of hepatitis. Conclusions: Our observation raises the possibility that elevated γ-glutamyltransferase could be a sentinel marker for AdV hepatitis, which prompts elaborated monitoring of AdV load and targeted treatment.

Original languageEnglish
Pages (from-to)857-863
Number of pages7
JournalJournal of Infection and Chemotherapy
Volume21
Issue number12
DOIs
Publication statusPublished - 01-12-2015
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

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